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- Title
Absence of Persistent Hepatitis E Virus Infection in Antibody-Deficient Patients Is Associated With Transfer of Antigen-Neutralizing Antibodies From Immunoglobulin Products.
- Authors
Ankcorn, Mike; Moreira, Fernando; Ijaz, Samreen; Symes, Andrew; Buckland, Matthew S; Workman, Sarita; Warburton, Fiona; Tedder, Richard S; Lowe, David M
- Abstract
<bold>Background: </bold>Persistent hepatitis E virus (HEV) infection is described in a number of immunosuppressive conditions. We aimed to determine the risk of persistent HEV infection in patients with primary or secondary antibody deficiency.<bold>Methods: </bold>Two hundred forty-five antibody-deficient patients receiving regular immunoglobulin replacement therapy were tested for HEV RNA and anti-HEV immunoglobulin G (IgG). Immunoglobulin products and plasma specimens obtained from 9 antibody-deficient patients before and after intravenous immunoglobulin (IVIG) therapy, 5 recently treated patients with persistent HEV infection, and 5 healthy patients recovered from acute HEV infection were analyzed for anti-HEV IgG and for antibody reacting with HEV antigen.<bold>Results: </bold>No antibody-deficient patient had detectable plasma HEV RNA. Anti-HEV IgG was detected in 38.8% of patients. All 10 immunoglobulin products tested contained anti-HEV capable of neutralizing HEV antigen. Plasma samples collected following IVIG infusion therapy demonstrated a higher anti-HEV IgG level and neutralizing activity, compared with samples collected before IVIG therapy. Neutralizing activity was similar to that in healthy patients with recent acute HEV infection.<bold>Conclusion: </bold>The risk of persistent HEV infection in patients with antibody deficiency appears extremely low. This may be due to passive seroprotection afforded by the ubiquitous presence of anti-HEV in immunoglobulin replacement products.
- Subjects
HEPATITIS E virus; CHRONIC diseases; DEFICIENCY diseases; IMMUNOGLOBULINS; INTRAVENOUS immunoglobulins; THERAPEUTIC use of immunoglobulins; IMMUNOLOGICAL deficiency syndrome complications; COMPARATIVE studies; HEPATITIS E; HEPATITIS viruses; IMMUNOLOGICAL deficiency syndromes; RESEARCH methodology; MEDICAL cooperation; RESEARCH; RNA; VIRAL antibodies; EVALUATION research; CROSS-sectional method
- Publication
Journal of Infectious Diseases, 2019, Vol 219, Issue 2, p245
- ISSN
0022-1899
- Publication type
journal article
- DOI
10.1093/infdis/jiy504